Interconnected implants and methods

ABSTRACT

An apparatus, system, and method may be used to replace a natural or artificial articular surface of a joint, and to repair a bone that is associated with the joint. In some embodiments, the apparatus, system, and method may include a joint replacement prosthesis with a prosthetic articular surface, a support structure securable to the bone, and a first attachment interface. The system may also include a bone plate with a bone engagement surface securable to the bone on either side of a fracture formed in the bone, or a damaged area of the bone. The bone plate may include a second attachment interface that is attachable to the first attachment interface of the joint replacement prosthesis in order to couple the bone plate to the joint replacement prosthesis.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional PatentApplication Ser. No. 62/750,781 entitled “INTERCONNECTED HIP IMPLANTSAND METHODS,” which was filed on Oct. 25, 2018 (Attorney Docket No.RET-1PROV), the disclosure of which is incorporated herein by referencein its entirety.

TECHNICAL FIELD

The present disclosure relates to surgical devices, systems, andmethods. More specifically, the present disclosure relates tointerconnected joint prosthesis implants and bone plates for replacingan articulating surface of a joint, as well as for repairing one or morebones associated with the joint.

BACKGROUND

Joint arthroplasty procedures are surgical procedures in which one ormore articulating surfaces of a joint are replaced with prostheticarticulating surfaces. Such procedures are becoming increasinglycommonplace.

Some joint replacements are necessitated by trauma. In such cases, itmay be desirable to repair one of the bones associated with, or adjacentto, the joint as part of the same surgical procedure in which a partialor full joint replacement is carried out. Furthermore, in some cases, aprevious joint arthroplasty procedure may need to be revised, forexample, by removing one or more previously implanted components andinserting new components. Sometimes in the context of revision, repairof a bone fracture is needed, along with the partial or full jointreplacement.

In one non-limiting example, the greater trochanter of a femur mayreceive significant loading, particularly after a hip replacement iscarried out that replaces the ball of the femur with a prosthetic ball.Accordingly, in this example, there may be a need to repair a fractureof the greater trochanter at the time the joint is first replaced, or atthe time of revision of the first joint replacement. Known jointreplacement and fracture repair systems often lack sufficient implantstability and interoperability.

SUMMARY

A system may be used to replace a natural or artificial articularsurface of a joint, and to repair a bone that is associated with thejoint. The joint may be a hip or shoulder joint, and the bone may be afemur or humerus, as two non-limiting examples.

In one embodiment, the system may include a joint replacement prosthesiswith a prosthetic articular surface, a support structure securable tothe bone, and a first attachment interface. The system may also includea bone plate with a bone engagement surface securable to the bone oneither side of a fracture formed in the bone, and a second attachmentinterface that is attachable to the first attachment interface of thejoint replacement prosthesis in order to couple the bone plate to thejoint replacement prosthesis.

In various embodiments of the system, the joint replacement prosthesismay include at least one of: a femoral joint replacement prosthesis; atibial joint replacement prosthesis; a fibular joint replacementprosthesis; a humeral joint replacement prosthesis; a clavicle jointreplacement prosthesis; a radial joint replacement prosthesis; an ulnarjoint replacement prosthesis; a digital joint replacement prosthesis;and an intramedullary nail.

The system may also include a fastening system configured to engage thesecond attachment interface with the first attachment interface andcouple the bone plate to the joint replacement prosthesis. In at leastsome embodiments, the fastening system may include a bolt and a washer.In at least some embodiments, the second attachment interface of thebone plate may be attachable to the first attachment interface of thejoint replacement prosthesis at any of a first plurality of relativeorientations about a first axis, and at any of a second plurality ofrelative orientations about a second axis, wherein the second axis isorthogonal to the first axis. The first attachment interface may includea dome having a first generally semispherical shape with a first radius.The second attachment interface may include a recess having a secondgenerally semispherical shape with a second radius, wherein the secondgenerally semispherical shape of the recess is complementary to thefirst generally semispherical shape of the dome. The first generallysemispherical shape and the second generally semispherical shape mayhave substantially the same radius.

The bone plate of the system may further include at least one armextending proximate the second attachment interface, at least onecentral expanse coupled to the at least one arm, and at least one boneengagement feature coupled to the at least one central expanse. One ormore of the at least one arm, the at least one central expanse, and theat least one bone engagement feature may be bendable, such that the oneor more of the at least one arm, the at least one central expanse, andthe at least one bone engagement feature can be shaped to conform to atleast one surface of the bone.

The at least one central expanse of the bone plate of the system mayfurther include an aperture formed in the at least one central expansein order to facilitate flexure of the at least one central expanse sothat the at least one central expanse can be shaped to conform to the atleast one surface of the bone. The at least one central expanse may besecurable to the bone on a first side of the fracture that is formed inthe bone, via a first bone engagement feature, and a second side of thefracture that is formed in the bone, via a second bone engagementfeature.

In at least one embodiment of the system, the at least one arm may befurther configured to allow the at least one central expanse totranslate with respect to the at least one arm to in order to compressthe at least one central expanse against the at least one surface of thebone.

In at least one embodiment of the system, the first attachment interfaceand the second attachment interface may be further configured to allowfor rotational adjustment of the bone plate with respect to the jointreplacement prosthesis.

In a particular embodiment, an apparatus for replacing a natural orartificial articular surface of a hip joint and for repairing a greatertrochanter of a femur associated with the hip joint may include a hipprosthesis with a neck that is securable to the femur associated withthe hip joint, an arm coupled to the neck, a prosthetic ball comprisingan articular surface, wherein the prosthetic ball is couplable to thearm of the hip prosthesis, and a first attachment interface formed on asuperior surface of the hip prosthesis. The apparatus may furtherinclude a bone plate with a bone engagement surface that is securable tothe greater trochanter of the femur on either side of a fracture formedin the greater trochanter of the femur, and a second attachmentinterface that is attachable to the first attachment interface of thehip prosthesis in order to couple the bone plate to the hip prosthesis.

The apparatus may further include a fastening system configured toengage the second attachment interface with the first attachmentinterface and couple the bone plate to the hip prosthesis. In at leastone embodiment, the fastening system may include a bolt and a washer. Insome embodiments, the second attachment interface of the bone plate maybe attachable to the first attachment interface of the hip prosthesis atany of a first plurality of relative orientations about a first axis,and at any of a second plurality of relative orientations about a secondaxis, wherein the second axis is orthogonal to the first axis. The firstattachment interface may include a dome having a first generallysemispherical shape with a first radius. The second attachment interfacemay include a recess having a second generally semispherical shape witha second radius, wherein the second generally semispherical shape of therecess is complementary to the first generally semispherical shape ofthe dome. The first generally semispherical shape and the secondgenerally semispherical shape may have substantially the same radius.

The bone plate of the apparatus may further include at least one armextending proximate the second attachment interface, at least onecentral expanse coupled to the at least one arm, and at least one boneengagement feature coupled to the at least one central expanse. One ormore of the at least one arm, the at least one central expanse, and theat least one bone engagement feature may be bendable, such that the oneor more of the at least one arm, the at least one central expanse, andthe at least one bone engagement feature can be shaped to conform to atleast one surface of the greater trochanter of the femur.

The at least one central expanse of the bone plate of the apparatus mayfurther include an aperture formed in the at least one central expansein order to facilitate flexure of the at least one central expanse sothat the at least one central expanse can be shaped to conform to the atleast one surface of the greater trochanter of the femur. The at leastone central expanse may be securable to the bone on a first side of thefracture that is formed in the greater trochanter of the femur, via afirst bone engagement feature, and a second side of the fracture that isformed in the greater trochanter of the femur, via a second boneengagement feature.

In at least one embodiment of the apparatus, the at least one arm may befurther configured to allow the at least one central expanse totranslate with respect to the at least one arm to in order to compressthe at least one central expanse against the at least one surface of thegreater trochanter of the femur.

In at least one embodiment of the apparatus, the first attachmentinterface and the second attachment interface may be further configuredto allow for rotational adjustment of the bone plate with respect to thehip prosthesis. In certain embodiments, the first attachment interfaceand the second attachment interface may be configured to allow fordiscrete rotational adjustments of the bone plate with respect to thehip prosthesis from among a plurality of different discrete rotationalpositions. In other embodiments, the first attachment interface and thesecond attachment interface may be configured to allow for an infinitenumber of rotational adjustment positions between the bone plate and thehip prosthesis.

According to another embodiment, a method of replacing a natural orartificial articular surface of a joint and repairing a bone associatedwith the joint may include coupling a joint replacement prosthesis tothe bone associated with the joint, replacing an articular surface ofthe joint with a prosthetic articular surface of the joint replacementprosthesis that is coupled to the bone associated with the joint,coupling a bone plate to the joint replacement prosthesis, and securingthe bone plate proximate a damaged area of the bone to facilitate repairof the damaged area of the bone associated with the joint.

The method may also include bending at least one of: an arm of the boneplate, a central expanse of the bone plate, and a bone engagementfeature of the bone plate, in order to u shape the bone plate to conformto at least one surface of the bone associated with the joint.

The method may also include translating the central expanse of the boneplate with respect to the arm of the bone plate and compressing thecentral expanse of the bone plate against at least one surface of thebone associated with the joint prior to securing the bone plate to thebone associated with the joint.

The method may also include rotating the bone plate to a desiredposition with respect to the joint replacement prosthesis prior tosecuring the bone plate to the bone associated with the joint.

In various embodiments of the method, the joint replacement prosthesismay include at least one of: a femoral joint replacement prosthesis; atibial joint replacement prosthesis; a fibular joint replacementprosthesis; a humeral joint replacement prosthesis; a clavicle jointreplacement prosthesis; a radial joint replacement prosthesis; an ulnarjoint replacement prosthesis; a digital joint replacement prosthesis;and an intramedullary nail.

These and other features and advantages of the present disclosure willbecome more fully apparent from the following description and appendedclaims, or may be learned by the practice of the systems and methods setforth hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

Exemplary embodiments of the disclosure will become more fully apparentfrom the following description and appended claims, taken in conjunctionwith the accompanying drawings. Understanding that these drawings depictonly exemplary embodiments and are, therefore, not to be consideredlimiting of the scope of the appended claims, the exemplary embodimentsof the present disclosure will be described with additional specificityand detail through use of the accompanying drawings in which:

FIG. 1A is a perspective view of a hip implant system 100 implanted in afemur, according to an embodiment of the present disclosure;

FIG. 1B is a close up perspective view of the hip implant system 100 ofFIG. 1A;

FIG. 2A is a front elevation, section view of the hip implant system 100shown in FIG. 1A;

FIG. 2B is a close up view of the hip implant system 100 shown in FIG.2A;

FIG. 3 shows the hip implant system 100 shown of FIG. 2A (without thefemur), illustrating the fastening system 114 and first and secondattachment interfaces 300, 310 of the hip implant system 100;

FIG. 4A illustrates an exploded view of a hip implant system 500,according to another embodiment of the present disclosure;

FIG. 4B illustrates a side view of the hip implant system 500 of FIG. 4Ain assembled form;

FIG. 5 illustrates a front elevation, section view of a hip implantsystem 400, according to another embodiment of the present disclosure;

FIG. 6 illustrates a front elevation, section view of a hip implantsystem 600, according to another embodiment of the present disclosure;

FIG. 7A illustrates a top view of a hip prosthesis 710 with a keyed hole720 formed therein, according to another embodiment of the presentdisclosure;

FIG. 7B illustrates a top view of the hip prosthesis 710 of FIG. 7Acoupled to a bone plate 712 via an offset arm 730;

FIG. 8A illustrates an exploded top view of a hip implant system 800,according to another embodiment of the present disclosure;

FIG. 8B illustrates an exploded bottom view of the hip implant system800 of FIG. 8A;

FIG. 9A illustrates an exploded top view of a hip implant system 900,according to another embodiment of the present disclosure;

FIG. 9B illustrates an exploded bottom view of the hip implant system900 of FIG. 9A;

FIG. 10 illustrates an exploded view of a hip implant system 1000,according to another embodiment of the present disclosure;

FIG. 11 illustrates an exploded view of a hip implant system 2000,according to another embodiment of the present disclosure;

FIG. 12 illustrates an exploded view of a hip implant system 3000,according to another embodiment of the present disclosure;

FIG. 13 illustrates an exploded view of a humeral implant system 4000,according to another embodiment of the present disclosure; and

FIG. 14 illustrates a flowchart of a method 5000 for replacing a naturalor artificial articular surface of a joint and repairing a boneassociated with the joint, according to an embodiment of the disclosure.

It will be understood that the Figures are for purposes of illustratingthe concepts of the present disclosure and may not be drawn to scale.Furthermore, the Figures illustrate exemplary embodiments and do notrepresent limitations to the scope of the present disclosure.

DETAILED DESCRIPTION

Exemplary embodiments of the present disclosure will be best understoodby reference to the Figures, wherein like parts are designated by likenumerals throughout. It will be readily understood that the componentsof the present disclosure, as generally described and illustrated in theFigures herein, could be arranged and designed in a wide variety ofdifferent configurations. Thus, the following more detailed descriptionof the embodiments of the apparatus, systems, and methods, asrepresented in the Figures, is not intended to limit the scope of thepresent disclosure, as claimed in this or any other application claimingpriority to this application, but is merely representative of exemplaryembodiments of the present disclosure.

Standard medical directions, planes of reference, and descriptiveterminology are employed in this specification. For example, anteriormeans toward the front of the body. Posterior means toward the back ofthe body. Superior means toward the head. Inferior means toward thefeet. Medial means toward the midline of the body. Lateral means awayfrom the midline of the body. Axial means toward a central axis of thebody. Abaxial means away from a central axis of the body. Ipsilateralmeans on the same side of the body. Contralateral means on the oppositeside of the body. A sagittal plane divides a body into right and leftportions. A midsagittal plane divides the body into bilaterallysymmetric right and left halves. A coronal plane divides a body intoanterior and posterior portions. A transverse plane divides a body intosuperior and inferior portions. These descriptive terms may be appliedto an animate or inanimate body.

The phrases “connected to,” “coupled to” and “in communication with”refer to any form of interaction between two or more entities, includingmechanical, electrical, magnetic, electromagnetic, fluid, and thermalinteraction. Two components may be functionally coupled to each othereven though they are not in direct contact with each other. The term“abutting” refers to items that are in direct physical contact with eachother, although the items may not necessarily be attached together. Thephrase “fluid communication” refers to two features that are connectedsuch that a fluid within one feature is able to pass into the otherfeature.

The word “exemplary” is used herein to mean “serving as an example,instance, or illustration.” Any embodiment described herein as“exemplary” is not necessarily to be construed as preferred oradvantageous over other embodiments. While the various aspects of theembodiments are presented in drawings, the drawings are not necessarilydrawn to scale unless specifically indicated.

FIGS. 1A-3 illustrate various views of a hip implant system 100,according to one embodiment of the present disclosure. Specifically,FIG. 1A is a perspective view of the hip implant system 100 implanted ina femur 102; FIG. 1B is a close up perspective view of the hip implantsystem 100 of FIG. 1A; FIG. 2A is a front elevation, section view of thehip implant system 100 of FIG. 1A; FIG. 2B is a close up view of the hipimplant system 100 shown in FIG. 2A; and FIG. 3 shows the hip implantsystem 100 of FIG. 2A without the femur 102, to illustrate a fasteningsystem 114 and the first and second attachment interfaces 300, 310 ofthe hip implant system 100.

As shown in FIGS. 1A-2B, the femur 102 may have a body 104, a ball 106,and a greater trochanter 108. The hip implant system 100 may be designedto replace one or more natural articulating surfaces of the ball 106,and may also be designed to repair and/or strengthen the greatertrochanter 108. Thus, the hip implant system 100 may include a hipprosthesis 110 and a bone plate 112, which may be secured together via afastening system 114.

The hip prosthesis 110 may have the configuration and components of anyhip implant known in the art. The hip prosthesis 110 may be designed asa revision implant that replaces a prior hip prosthesis (not shown) thatis no longer suitable due to wear, loosening, infection, and/or forother reasons. The hip prosthesis 110 may have a stem 120, a neck 122,and an arm 124. The stem 120 may reside within the intramedullary canalof the femur 102, specifically within the body 104 of the femur 102, andmay thus provide a support structure to support the hip prosthesis 110relative to the femur 102. The neck 122 may optionally also residewithin the intramedullary canal of the femur 102, proximal to the stem120. The stem 120 and the neck 122 may optionally be separate pieces,allowing for stems with different sizes and/or lengths to be used incombination with one or more necks.

As shown, the neck 122 may be formed as a single piece with the arm 124.The arm 124 may have a Morse taper or other interface to which aprosthetic ball (not shown) may be attached. The prosthetic ball mayreplace the ball 106 of the femur 102, which may be removed, or in thecase of a revision surgery, may already have been removed and replacedwith a previous prosthetic ball. Modularity between the prosthetic balland the arm 124 may permit a variety of different prosthetic balls andarms to be used interchangeably with each other. Thus, the surgeon may,in some embodiments, make up the hip prosthesis 110 by selecting thestem 120 from a plurality of stems, selecting the neck 122 and the arm124 from a plurality of neck and arm components, and selecting theprosthetic ball from a plurality of prosthetic balls.

The bone plate 112 may be designed to remedy a fracture or weakness (notshown) in the greater trochanter 108. The bone plate 112 may have theshape and features of any bone plate known in the art. The bone plate112 may have at least one bone engagement feature 132, at least onecentral expanse 130, and/or at least one arm 134.

The central expanse 130 is shown with a shape that generally conforms tothat of the greater trochanter 108, with an oval aperture 136 thatfacilitates flexure of the central expanse 130 to enable the centralexpanse 130 to bend into greater conformity with the surface of thegreater trochanter 108, as the central expanse 130 is installed. Theoval aperture 136 may also reduce the weight of the central expanse 130.

The bone engagement features 132 may have any configuration known in theart. As embodied in FIGS. 1A-3, the bone engagement features 132 may beeyelets through which fasteners, such as bone screws (not shown), may beinserted to secure the periphery of the central expanse 130 to thegreater trochanter 108. In other embodiments, alternative bone fasteningmethods, such as pins or spikes (not shown), may be used to secure thebone plate 112 to the greater trochanter 108 in other ways.

The arm 134 may have a gooseneck shape that extends over the superioraspect of the greater trochanter 108, and then distally toward theproximal end of the intramedullary canal of the femur 102, where theproximal end of the neck 122 is located. The arm 134 may terminate in aring 138 that may be used to secure the arm 134 of the bone plate 112 tothe neck 122 of the hip prosthesis 110. Like the central expanse 130,the arm 134 may also be thin enough to be somewhat malleable, such thatthe arm 134 may be bent into closer conformity with the superior end ofthe femur 102 during implantation.

The bone plate 112 may also be a modular component of the hip implantsystem 100. In some examples, the bone plate 112 may be selected from anumber of differently-sized and/or differently-shaped bone plates. As avariety of fractures may occur in the greater trochanter 108, such boneplates may have different configurations, each of which may address aspecific fracture type and/or fracture severity.

The hip prosthesis 110 and the bone plate 112 may be secured togetherthrough use of the fastening system 114. In some embodiments, thefastening system 114 may secure the bone plate 112 to the hip prosthesis110 at any of a plurality of relative orientations. Thus, the fasteningsystem 114 may be operable to secure the hip prosthesis 110 to the boneplate 112 with a variety of bone geometries. The fastening system 114may further secure two or more components of the hip prosthesis 110together. As embodied in FIGS. 1A-3, the fastening system 114 may securethe stem 120 to the neck 122, in addition to securing the hip prosthesis110 to the bone plate 112.

As shown in FIGS. 2B and 3, the neck 122 of the hip prosthesis 110 mayhave a bore 240 that extends the entire length through the neck 122. Thestem 120 of the hip prosthesis 110 may have a tapered extension 242 thatis inserted into a counterbore 244 of the bore 240. The taperedextension 242 may have a threaded hole 246. The neck 122 may also have ashoulder 248, which may protrude from the intramedullary canal of thefemur 102 after implantation of the hip prosthesis 110.

The fastening system 114 may include a bolt 250 and a washer 252. Thebolt 250 may have a head 260, a threaded distal end 262, and a shank 264extending from the head 260 to the threaded distal end 262. The washer252 may have a head engagement surface 270 and a ring u engagementsurface 272. Prior to use of the fastening system 114, the stem 120 andthe neck 122 may be assembled as shown in FIGS. 2A-3, with the taperedextension 242 of the stem 120 residing in the counterbore 244 of thebore 240 of the neck 122. Thus, the stem 120 and the neck 122 may beprovisionally attached together, for example, via a press fit betweenthe tapered extension 242 and the counterbore 244.

The bolt 250 may be inserted through the ring 138 of the bone plate 112and into the bore 240 of the neck 122 such that the threaded distal end262 of the bolt 250 is inserted into the threaded hole 246 of thetapered extension 242. The head 260 may then be rotated, for example,with a driver (not shown) that mates with a complementary shape formedin the head 260, to cause the threaded distal end 262 of the bolt 250 toengage the threads of the threaded hole 246. The bolt 250 may betightened such that the head 260 is drawn to compress the ring 138 andthe washer 252 between the head 260 and the shoulder 248 of the neck122. This tightening of the bolt 250 may secure the stem 120 to the neck122, and may also secure the bone plate 112 to the hip prosthesis 110.

After the bolt 250 has been tightened, the bone plate 112 may bedeformed as needed to cause the bone plate 112 to conform more closelyto the shape of the greater trochanter 108 and the proximal surface ofthe femur 102. In some embodiments, the bone plate 112 may not besecured to the femur 102 until after the bone plate 112 has been securedto the hip prosthesis 110. A pair of pliers (not shown) or otherinstrumentation may be used to bend the bone plate 112 to the desiredshape prior to attachment of the bone plate 112 to the femur 102.

In some embodiments, it may be desirable for the bone plate 112 to havea polyaxially-adjustable attachment to the hip prosthesis 110, so thatthe orientation of the bone plate 112, relative to the hip prosthesis110, can be adjusted via rotation about at least two orthogonal axes.Further, in some embodiments, adjustability about three orthogonal axesmay be provided. The hip implant system 100 may provide suchadjustability, as will be shown and described in connection with FIG. 3.

FIG. 3 shows the fastening system 114 and the first and secondattachment interfaces 300, 310 of the hip implant system 100 of FIGS.1A-2B. Specifically, the portion of the hip prosthesis 110 that issecured to the bone plate 112, i.e., the shoulder 248 of the neck 122,may define a first attachment interface 300. Similarly, the portion ofthe bone plate 112 that is secured to the hip prosthesis 110, i.e., thering 138, may define a second attachment interface 310. The firstattachment interface 300 and the second attachment interface 310 may beshaped to allow the polyaxial adjustability mentioned previously.

Specifically, the first attachment interface 300 may be a dome with agenerally semispherical shape with a first radius 320. Similarly, thesecond attachment interface 310 on the bottom of the ring 138 may be arecess with a semispherical spherical shape that is complementary tothat of the dome of the first attachment interface 300. The recess mayalso be curved at the first radius 320, or at a second radius that issubstantially equal to the first radius 320. Thus, before the bolt 250is tightened, the position and orientation of the ring 138 on theshoulder 248 may be adjusted. Such adjustment may include rotation aboutany of three axes, for example, a longitudinal axis 350, a lateral axis360, and a transverse axis 370. Since the ring 138 may move along anarcuate pathway on the first attachment interface 300 of the shoulder248, such adjustment may further include some translation along thelateral axis 360 and/or the transverse axis 370. Thus, the positionand/or orientation of the bone plate 112 relative to the hip prosthesis110 may be adjusted for optimal positioning of the bone plate 112 on thefemur 102.

In some embodiments, the first attachment interface 300 and the secondattachment interface 310 may be textured so as to promote securefixation together when the bolt 250 is tightened. For example, the firstattachment interface 300 and the second attachment interface 310 may beknurled or otherwise roughened with any known pattern. In someembodiments, one or both of the first attachment interface 300 and thesecond attachment interface 310 may deform in response to tightening ofthe bolt 250 to provide additional secure fixation.

Further, any of the components of the hip implant system 100, or anyother implant system described herein, may have a coating or surfacetexturing that promotes bone in-growth. In some embodiment,nano-textured surfaces may be present. In some configurations, suchsurfaces may have protrusions and recesses that engage each other in amanner that may be termed “metal Velcro.” For example, the firstattachment interface 300 and the second attachment interface 310 mayeach have such nano-texturing, with a matrix of protrusions and recesseson each of the first attachment interface 300 and the second attachmentinterface 310 such that the protrusions in each engage the recesses inthe other. Thus, a very secure fixation may be obtained between the hipprosthesis 110 and the bone plate 112. Such texturing may be used inother mating components of the any implant system described herein.

FIGS. 4A and 4B illustrate two different views of a hip implant system500 incorporating an alternative fastening system 515 configured toseparately couple the bone plate 512 and the stem 520 to the hipprosthesis 510. Specifically, FIG. 4A illustrates an exploded view ofthe hip implant system 500 and FIG. 4B illustrates a side view of thehip implant system 500 assembled together. FIG. 4B also illustrates thehip prosthesis 510 and the stem 520 as “see-through” parts, in order tobetter illustrate how the first and second fasteners 551, 553 may beutilized to couple the bone plate 512 and the stem 520 to the hipprosthesis 510.

Specifically, the first fastener 551 and washer 552 may be utilized tocouple the bone plate 512 to the hip prosthesis 510 via a threaded hole555 formed in the proximal end of the hip prosthesis 510. The stem 520may also be separately coupled to the hip prosthesis 510 via the secondfastener 553. In the embodiment shown, the second fastener 553 may havea smaller diameter than the first fastener 551 to allow the secondfastener 553 to pass through the threaded hole 555 formed in theproximal end of the hip prosthesis 510 and secure the stem 520 to thehip prosthesis 510. The stem 520 may have a tapered extension 542 thatmay be inserted into a counterbore 544 formed in the distal end of thehip prosthesis 510. The tapered extension 542 may also have a threadedhole 546 formed therein. In this manner, the stem 520 may be coupled tothe hip prosthesis 510 via a press fit formed between the taperedextension 542 and the counterbore 544 as the second fastener 553 engagesthe threaded hole 546 formed in the tapered extension 542. In thismanner, both the bone plate 512 and the stem 520 may each be separatelyand independently couplable to the hip prosthesis 510. It will also beunderstood that the first and second fasteners 551, 553 may be bolts,screws, or any other suitable fastener known in the art.

In at least some embodiments, the proximal end of the hip prosthesis 510may additionally include a keyed hole and/or at least one surfaceconfigured to allow for rotational u adjustment of the bone plate 512with respect to the hip prosthesis 510, as will be described below inmore detail with respect to FIGS. 7A-9B.

FIG. 5 illustrates a front elevation, section view of a hip implantsystem 400 coupled to an acetabular cup 420 via the hip prosthesis 110which is also coupled to the bone plate 112. The hip implant system 400may be similar in construction to other hip implant systems describedherein. However, the stem 401 of the hip implant system 400 mayadditionally include one or more transverse passages 405 formed in thedistal end of the stem 401 which may be configured to receive one ormore fasteners 410 therethrough in order to provide additionalsecurement of the stem 401 to the femur 102.

FIG. 6 illustrates a front elevation, section view of a hip implantsystem 600, according to another embodiment of the present disclosure.The hip implant system 600 may be similar in construction to other hipimplant systems described herein. However, the hip implant system 600may additionally include an adjustable arm mechanism 634 that may beconfigured to adjustably couple the bone plate 612 to the hip prosthesis110 at a plurality of different distances with respect to the hipprosthesis 110. The adjustable arm mechanism 634 may be coupled to thehip prosthesis 110 via a first fastener 251. The bone plate 612 may becoupled to the adjustable arm mechanism 634 via a second fastener 254.The second fastener 254 may be configured to move the bone plate 612toward the hip prosthesis 110 in order to compress the bone plate 612against a greater trochanter of a femur (not shown in FIG. 6), as thesecond fastener 254 is threadably engaged with the adjustable armmechanism 634. Conversely, the second fastener 254 may be configured tomove the bone plate 612 away from the hip prosthesis 110 in order todecompress the bone plate 612 away from the greater trochanter of thefemur, as the second fastener 254 is threadably disengaged with theadjustable arm mechanism 634. In this manner, the adjustable armmechanism 634 may provide for additional conformity of the bone plate612 with respect to the greater trochanter of the femur. Moreover, in atleast some embodiments, the adjustable arm mechanism 634 may be furtherconfigured to rotate about the hip prosthesis 110 via a keyed or toothedmechanism/connection (not shown in FIG. 6) formed between the adjustablearm mechanism 634 and the hip prosthesis 110, as will be discussed belowin more detail with respect to FIGS. 7A and 7B.

FIGS. 7A and 7B illustrate two top views of a hip prosthesis 710,according to another embodiment of the present disclosure. Specifically,FIG. 7A shows a top view of the hip prosthesis 710 illustrating a keyedhole 720 formed in the proximal end of the hip prosthesis 710 and FIG.7B shows a top view of the hip prosthesis 710 coupled to a bone plate712 via an offset arm 730. The keyed hole 720 may include one or morerecesses 740 which may be shaped and/or configured to receive one ormore complementarily shaped teeth (not shown) formed on the offset arm730 at the point where the offset arm 730 connects to the hip prosthesis710 via insertion into the keyed hole 720. In this manner, the boneplate 712 may be selectively rotated relative to the hip prosthesis 710in order to adjust an angular position of the bone plate 712 withrespect to the hip prosthesis 710 in order to achieve a betterconformity of the bone plate 712 with a surface of the femur 102.Moreover, the offset arm 730 may also help facilitate better positioningof the bone plate 712 with respect to the femur 102 and/or the hipprosthesis 710, as the bone plate 712 is selectively rotated andpositioned relative to the hip prosthesis 710. Once the bone plate 712has been selectively rotated and positioned relative to the hipprosthesis 710, the bone plate 712 may be secured to the hip prosthesis710 via a suitable fastener (not shown) which may be inserted throughthe offset arm 730 and into the keyed hole 720.

FIGS. 8A and 8B illustrate exploded views of another example hip implantsystem 800 including a hip prosthesis 810 and a bone plate 812 that mayrotate relative to the hip prosthesis 810. The hip implant system 800may also include a hip stem (not shown) which may be coupled to thedistal end of the hip prosthesis 810.

The bone plate 812 may be coupled to the proximal end of the hipprosthesis 810 via the fastener 850 and washer 852. The fastener 850 andwasher 852 may be configured to apply a compression force to the ring838 of the bone plate 812 in order to couple the bone plate 812 to thehip prosthesis 810. The bone plate 812 may be rotated to any number ofdifferent discrete angular positions relative to the hip prosthesis 810prior to securing the bone plate 812 to the hip prosthesis 810. Thedistal surface 802 of the ring 838 may include one or more teeth 804formed thereon and the proximal surface 801 of the hip prosthesis 810may include one or more recesses 803 formed therein. The one or moreteeth 804 formed on the distal surface 802 of the ring 838 may beconfigured to fit within the one or more recesses 803 formed in theproximal surface 801 of the hip prosthesis 810, in order to prevent thebone plate 812 from further rotation with respect to the hip prosthesis810 after the bone plate 812 has been secured to the hip prosthesis 810.In this manner, the attachment interfaces between the bone plate 812 andthe hip prosthesis 810 may be configured to allow for rotationaladjustment of the bone plate 812 with respect to the hip prosthesis 810to any number of different selectable discrete angular or rotationalpositions.

FIGS. 9A and 9B illustrate exploded views of another example hip implantsystem 900 including an intramedullary nail 910 and a bone plate 912that may rotate relative to the intramedullary nail 910. The bone plate912 may be coupled to the proximal end of the intramedullary nail 910via the fastener 950 and washer 952. The fastener 950 and washer 952 maybe configured to apply a compression force to the ring 938 of the boneplate 912 in order to couple the bone plate 912 to the intramedullarynail 910. The bone plate 912 may be rotated to any number of differentdiscrete angular positions relative to the intramedullary nail 910 priorto securing the bone plate 912 to the intramedullary nail 910. Thedistal surface 902 of the ring 938 may include one or more teeth 904formed thereon and the proximal surface 901 of the intramedullary nail910 may include one or more recesses 903 formed therein. The one or moreteeth 904 formed on the distal surface 902 of the ring 938 may beconfigured to fit within the one or more recesses 903 formed in theproximal surface 901 of the intramedullary nail 910, in order to preventthe bone plate 912 from further rotation with respect to theintramedullary nail 910 after the bone plate 912 has been secured to theintramedullary nail 910. In this manner, the attachment interfacesbetween the bone plate 912 and the intramedullary nail 910 may beconfigured to allow for rotational adjustment of the bone plate 912 withrespect to the intramedullary nail 910 to any number of differentselectable discrete angular or rotational positions.

It will be understood that any other suitable features may also beimplemented to achieve discrete angular or rotational adjustment of thebone plate with respect to the joint replacement prosthesis including,but not limited to: Torx shaped features, hex shaped features, or anymulti-side polygon shaped features, etc.

In other embodiments (not shown), the attachment interfaces between thebone plate and the joint replacement prosthesis may be configured toallow for an infinite number of rotational adjustment positions betweenthe bone plate and the joint replacement prosthesis via a frictionlocking mechanism. For example, each of the attachment interfaces may betextured so as to promote secure fixation when the attachment interfacesare coupled together via a compression force. For example, theattachment interfaces may be knurled, bead-blasted, sprayed with metalplasma, shot-peened, acid-etched, or otherwise roughened with any knownpattern that may form interlocking positive and negative features onopposing surfaces to resist rotation and/or shear and form surfaces thatare a friction-locked together. In some embodiments, one or both of theattachment interfaces may deform in response to a compression force toprovide additional secure fixation. In some configurations, theattachment interfaces may have protrusions and recesses that engage eachother in a manner that may be termed “metal Velcro.” For example, theattachment interfaces may each have nano-texturing, with a matrix ofprotrusions and recesses on each of the attachment interfaces such thatthe protrusions in each engage the recesses in the other. Examples ofsuch surface texturing may be found in at least PCT Application No.PCT/US19/16697 entitled “MEDICAL IMPLANT SURFACE TREATMENT AND METHOD”filed on Feb. 5, 2019 and claiming priority to U.S. Provisional PatentApplication Ser. No. 62/626,479, which was filed on Feb. 5, 2018. Bothof these references are incorporated herein by reference in theirentirety.

FIGS. 10-13 illustrate various examples of implant systems that may beconfigured to utilize a bone plate coupled to an implant. Specifically,FIG. 10 illustrates an exploded view of an example hip implant system1000 configured to utilize a bone plate that may be coupled to theimplant shown in FIG. 10; FIG. 11 illustrates an exploded view ofanother example hip implant system 2000 configured to utilize a boneplate that may be coupled to the implant shown in FIG. 11; FIG. 12illustrates an exploded view of another hip implant system 3000configured to utilize a bone plate that may be coupled to the implantshown in FIG. 12; and FIG. 13 illustrates an exploded view of a humeralimplant system 4000 configured to utilize a bone plate that may becoupled to the implant shown in FIG. 13.

However, it will also be understood that the implants, systems, andmethods presented herein are merely exemplary. Those of skill in the artwill recognize that the principles set forth herein could be applied toa wide variety of surgical procedures and implants. In particular, theimplants, systems, and methods set forth herein are not limited tofemoral hip implants or femoral greater trochanter plates, but may beused for a wide variety of joint arthroplasties, jointhemi-arthroplasties, and/or bone fractures. For example, such jointreplacement prostheses may include, but are not limited to, femoraljoint replacement prostheses, tibial joint replacement prostheses,fibular joint replacement prostheses, humeral joint replacementprostheses, clavicle joint replacement prostheses, radial jointreplacement prostheses, ulnar joint replacement prostheses, digitaljoint replacement prostheses, intramedullary nails, etc. Moreover, eachof these replacement prostheses may be combined with any bone platesystem described herein.

FIG. 10 illustrates an exploded view of an example hip implant system1000 configured to utilize the bone plate 112. The hip implant system1000 may include an intramedullary nail 1010 inserted within anintramedullary canal of the femur 102, a first hip prosthesis member1100 providing support to the femoral head 103 via the intramedullarynail 1010, and a second hip prosthesis member 1200 providing additionalsupport to the femoral head 103 via the intramedullary nail 1010. Thehip implant system 1000 may also be coupled to the bone plate 112 viathe bolt 250 and washer 252, in a similar fashion to other hip implantsystems described herein. In at least one embodiment, the hip implantsystem 1000 may also be polyaxially-adjustable relative to the boneplate 112, such that the bone plate 112 can be adjusted via rotationabout at least two orthogonal axes. In other embodiments, the hipimplant system 1000 may be polyaxially-adjustable relative to the boneplate 112 about three orthogonal axes.

FIG. 11 illustrates an exploded view of another example hip implantsystem 2000 configured to utilize the bone plate 112. The hip implantsystem 2000 may include an intramedullary nail 2010 inserted within anintramedullary canal of the femur 102, and a hip prosthesis member 2100providing support to the femoral head 103 via the intramedullary nail2010. The hip implant system 2000 may also be coupled to the bone plate112 via the bolt 250 and washer 252, in a similar fashion to other hipimplant systems described herein. In at least one embodiment, the hipimplant system 2000 may be polyaxially-adjustable relative to the boneplate 112, such that the bone plate 112 can be adjusted via rotationabout at least two orthogonal axes. In other embodiments, the hipimplant system 2000 may be polyaxially-adjustable relative to the boneplate 112 about three orthogonal axes.

FIG. 12 illustrates an exploded view of another example hip implantsystem 3000 configured to utilize the bone plate 112. The hip implantsystem 3000 may include an intramedullary nail 3010 inserted within anintramedullary canal of the femur 102, a first hip prosthesis member3100 providing support to the femoral head 103 via the intramedullarynail 3010, and a second hip prosthesis member 3200 providing additionalsupport to the femoral head 103 via the intramedullary nail 3010. Thehip implant system 3000 may also be coupled to the bone plate 112 viathe bolt 250 and washer 252, in a similar fashion to other hip implantsystems described herein. In at least one embodiment, the hip implantsystem 3000 may be polyaxially-adjustable relative to the bone plate112, such that the bone plate 112 can be adjusted via rotation about atleast two orthogonal axes. In other embodiments, the hip implant system3000 may be polyaxially-adjustable relative to the bone plate 112 aboutthree orthogonal axes.

FIG. 13 illustrates an exploded view of an example humeral implantsystem 4000 configured to utilize the bone plate 112. The humeralimplant system 4000 may include an intramedullary nail 4010 insertedwithin an intramedullary canal of the humerus 105, a first fastener 4100and a second fastener 4200 to couple the intramedullary nail 4010 to thehumerus 105, and one or more fasteners 4300 to provide support for thehumeral head 107 via the intramedullary nail 4010. The humeral implantsystem 4000 may also be coupled to a bone plate 112 via the bolt 250 andwasher 252 in similar fashion to other implant systems described herein.In at least one embodiment, the humeral implant system 4000 may bepolyaxially-adjustable relative to the bone plate 112, such that thebone plate 112 can be adjusted via rotation about at least twoorthogonal axes. In other embodiments, the humeral implant system 4000may be polyaxially-adjustable relative to the bone plate 112 about threeorthogonal axes.

FIG. 14 illustrates a flowchart of a method 5000 for replacing a naturalor artificial articular surface of a joint and repairing a boneassociated with the joint, according to an embodiment of the disclosure.

The method 5000 may begin with a step 5100 in which a joint replacementprosthesis may be coupled to a bone that is associated with a joint. Thejoint replacement prosthesis may include any type of joint replacementprosthesis including, but not limited to, femoral joint replacementprostheses, tibial joint replacement prostheses, fibular jointreplacement prostheses, humeral joint replacement prostheses, claviclejoint replacement prostheses, radial joint replacement prostheses, ulnarjoint replacement prostheses, digital joint replacement prostheses,intramedullary nails, etc.

Once the joint replacement prosthesis has been coupled to the boneassociated with a joint, the method 5000 may proceed to a step 5200 inwhich an articular surface of the joint may be replaced with aprosthetic articular surface of the joint replacement prosthesis.However, it will also be understood that in other embodiments, anarticular surface of the joint may not be replaced with a prostheticarticular surface of the joint replacement prosthesis. For example, ahip joint replacement prosthesis that comprises an intramedullary nailmay not include any additional structures that may replace an articularsurface of the hip joint with a prosthetic articular surface.

Once the articular surface of the joint may have been replaced with aprosthetic articular surface of the joint replacement prosthesis, themethod 5000 may proceed to a step 5300 in which a bone plate may becoupled to the joint replacement prosthesis. The bone plate may becoupled to the joint replacement prosthesis via any method describedherein, or via any other suitable method known in the art.

Once the bone plate has been coupled to the joint replacementprosthesis, the method 5000 may proceed to a step 5400 in which the boneplate may be secured proximate a damaged area of the bone, in order tofacilitate repair of the damaged area of the bone associated with thejoint. In at least one embodiment, the damaged area of the bone mayinclude a fracture that is formed in the bone associated with the joint.

Alternatively, or in addition thereto, the method 5000 may proceed to astep 5500 in which at least a portion of the bone plate may be bent inorder to shape the bone plate to conform to at least one surface of thebone associated with the joint. The bone plate may be bent prior tobeing secured proximate the damaged area of the bone.

Alternatively, or in addition thereto, the method 5000 may proceed to astep 5600 in which the bone plate may be translated with respect to anarm of the bone plate. The bone plate may also be compressed against theat least one surface of the bone associated with the joint, prior tosecuring the bone plate to the bone associated with the joint.

Alternatively, or in addition thereto, the method 5000 may proceed to astep 5700 in which the bone plate may be rotated to a desired positionwith respect to the joint replacement prosthesis, prior to securing thebone plate to the bone associated with the joint. The bone plate may berotated with respect to the joint replacement prosthesis according todiscrete or infinite rotational positions, as described herein, and themethod 5000 may end.

Any methods disclosed herein comprise one or more steps or actions forperforming the described method. One or more of the method steps and/oractions may be omitted from any of the methods disclosed herein.Moreover, any of the method steps and/or actions may be interchangedwith one another. In other words, unless a specific order of steps oractions is required for proper operation of the embodiment, the orderand/or use of specific steps and/or actions may be modified.

Reference throughout this specification to “an embodiment” or “theembodiment” means that a particular feature, structure or characteristicdescribed in connection with that embodiment is included in at least oneembodiment. Thus, the quoted phrases, or variations thereof, as recitedthroughout this specification are not necessarily all referring to thesame embodiment.

Similarly, it should be appreciated that in the above description ofembodiments, various features are sometimes grouped together in a singleembodiment, Figure, or description thereof for the purpose ofstreamlining the disclosure. This method of disclosure, however, is notto be interpreted as reflecting an intention that any claim require morefeatures than those expressly recited in that claim. Rather, as thefollowing claims reflect, inventive aspects lie in a combination offewer than all features of any single foregoing disclosed embodiment.Thus, the claims following this Detailed Description are herebyexpressly incorporated into this Detailed Description, with each claimstanding on its own as a separate embodiment. This disclosure d includesall permutations of the independent claims with their dependent claims.

Recitation in the claims of the term “first” with respect to a featureor element does not necessarily imply the existence of a second oradditional such feature or element. Elements recited inmeans-plus-function format are intended to be construed in accordancewith 35 U.S.C. § 112 Para. 6. It will be apparent to those having skillin the art that changes may be made to the details of theabove-described embodiments without departing from the underlyingprinciples set forth herein.

While specific embodiments and applications of the present disclosurehave been illustrated and described, it is to be understood that thescope of the appended claims is not limited to the precise configurationand components disclosed herein. Various modifications, changes, andvariations which will be apparent to those skilled in the art may bemade in the arrangement, operation, and details of the methods andsystems disclosed herein.

What is claimed is:
 1. A system for replacing a natural or artificialarticular surface of a joint and for repairing a bone associated withthe joint, the system comprising: a joint replacement prosthesiscomprising: a prosthetic articular surface; a support structuresecurable to the bone; and a first attachment interface; a bone platecomprising: a bone engagement surface securable to the bone on eitherside of a fracture formed in the bone; and a second attachment interfacethat is attachable to the first attachment interface of the jointreplacement prosthesis in order to couple the bone plate to the jointreplacement prosthesis; and a fastening system configured to engage thesecond attachment interface with the first attachment interface andcouple the bone plate to the joint replacement prosthesis; wherein: thesecond attachment interface of the bone plate is attachable to the firstattachment interface of the joint replacement prosthesis: at any of afirst plurality of relative orientations about a first axis; and at anyof a second plurality of relative orientations about a second axisorthogonal to the first axis; the first attachment interface comprisesan outwardly protruding feature having a first round shape with a firstradius; the second attachment interface comprises a recess having asecond round shape with a second radius; and the second generallysemispherical shape of the recess is complementary to the firstgenerally semispherical shape of the dome.
 2. The system of claim 1,wherein the joint replacement prosthesis comprises at least one of: afemoral joint replacement prosthesis; a tibial joint replacementprosthesis; a fibular joint replacement prosthesis; a humeral jointreplacement prosthesis; a clavicle joint replacement prosthesis; aradial joint replacement prosthesis; an ulnar joint replacementprosthesis; a digital joint replacement prosthesis; and anintramedullary nail.
 3. The system of claim 1, wherein the bone platefurther comprises: at least one arm extending proximate the secondattachment interface; at least one central expanse coupled to the atleast one arm; and at least one bone engagement feature coupled to theat least one central expanse, wherein one or more of the at least onearm, the at least one central expanse, and the at least one boneengagement feature is bendable, such that the one or more of the atleast one arm, the at least one central expanse, and the at least onebone engagement feature can be shaped to conform to at least one surfaceof the bone.
 4. The system of claim 3, wherein the at least one centralexpanse further comprises an aperture formed in the at least one centralexpanse in order to facilitate flexure of the at least one centralexpanse so that the at least one central expanse can be shaped toconform to the at least one surface of the bone, and the at least onecentral expanse is securable to the bone on: a first side of thefracture that is formed in the bone, via a first bone engagementfeature; and a second side of the fracture that is formed in the bone,via a second bone engagement feature.
 5. The system of claim 3, whereinthe at least one arm is configured to allow the at least one centralexpanse to translate with respect to the at least one arm to in order tocompress the at least one central expanse against the at least onesurface of the bone.
 6. The system of claim 1, wherein the firstattachment interface and the second attachment interface are furtherconfigured to allow for rotational adjustment of the bone plate withrespect to the joint replacement prosthesis.
 7. The system of claim 1,wherein: the outwardly projecting feature comprises a dome; the firstround shape comprises a first generally semispherical shape; and thesecond round shape comprises a second generally semispherical shape. 8.An apparatus for replacing a natural or artificial articular surface ofa hip joint and for repairing a greater trochanter of a femur associatedwith the hip joint, the apparatus comprising: a hip prosthesiscomprising: a neck that is securable to the femur associated with thehip joint; an arm coupled to the neck; a prosthetic ball comprising anarticular surface, wherein the prosthetic ball is couplable to the armof the hip prosthesis; and a first attachment interface formed on asuperior surface of the hip prosthesis; a bone plate comprising: a boneengagement surface that is securable to the greater trochanter of thefemur on either side of a fracture formed in the greater trochanter ofthe femur; and a second attachment interface that is attachable to thefirst attachment interface of the hip prosthesis in order to couple thebone plate to the hip prosthesis; and a fastening system configured toengage the second attachment interface with the first attachmentinterface and couple the bone plate to the hip prosthesis; wherein: thesecond attachment interface of the bone plate is attachable to the firstattachment interface of the hip prosthesis: at any of a first pluralityof relative orientations about a first axis; and at any of a secondplurality of relative orientations about a second axis orthogonal to thefirst axis; the first attachment interface comprises an outwardlyprotruding feature having a first round shape with a first radius; thesecond attachment interface comprises a recess having a second roundshape with a second radius; and the second generally semispherical shapeof the recess is complementary to the first generally semisphericalshape of the dome.
 9. The apparatus of claim 8, wherein the bone platefurther comprises: at least one arm extending proximate the secondattachment interface; at least one central expanse coupled to the atleast one arm; and at least one bone engagement feature coupled to theat least one central expanse, wherein one or more of the at least onearm, the at least one central expanse, and the at least one boneengagement feature is bendable, such that the one or more of the atleast one arm, the at least one central expanse, and the at least onebone engagement feature can be shaped to conform to at least one surfaceof the greater trochanter of the femur.
 10. The apparatus of claim 9,wherein the at least one central expanse further comprises an apertureformed in the at least one central expanse in order to facilitateflexure of the at least one central expanse so that the at least onecentral expanse can be shaped to conform to the at least one surface ofthe greater trochanter of the femur, and the at least one centralexpanse is securable to the bone on: a first side of the fracture thatis formed in the greater trochanter of the femur, via a first boneengagement feature; and a second side of the fracture that is formed inthe greater trochanter of the femur, via a second bone engagementfeature.
 11. The apparatus of claim 9, wherein the at least one arm isconfigured to allow the at least one central expanse to translate withrespect to the at least one arm to in order to compress the at least onecentral expanse against the at least one surface of the greatertrochanter of the femur.
 12. The apparatus of claim 8, wherein the firstattachment interface and the second attachment interface are furtherconfigured to allow for rotational adjustment of the bone plate withrespect to the hip prosthesis.
 13. The apparatus of claim 12, whereinthe first attachment interface and the second attachment interface areconfigured to allow for discrete rotational adjustments of the boneplate with respect to the hip prosthesis from among a plurality ofdifferent discrete rotational positions.
 14. The apparatus of claim 12,wherein the first attachment interface and the second attachmentinterface are configured to allow for an infinite number of rotationaladjustment positions between the bone plate and the hip prosthesis. 15.The method of claim 14, wherein: the outwardly projecting featurecomprises a dome; the first round shape comprises a first generallysemispherical shape; and the second round shape comprises a secondgenerally semispherical shape.
 16. A method of replacing a natural orartificial articular surface of a joint and repairing a bone associatedwith the joint, the method comprising: coupling a joint replacementprosthesis to the bone associated with the joint; replacing an articularsurface of the joint with a prosthetic articular surface of the jointreplacement prosthesis coupled to the bone associated with the joint;coupling a bone plate to the joint replacement prosthesis; securing thebone plate proximate a damaged area of the bone to facilitate repair ofthe damaged area of the bone associated with the joint; and with afastening system, engaging a second attachment interface of the boneplate with a first attachment interface of the joint replacementprosthesis to couple the bone plate to the joint replacement prosthesis:at any of a first plurality of relative orientations about a first axis;and at any of a second plurality of relative orientations about a secondaxis orthogonal to the first axis; wherein: the first attachmentinterface comprises an outwardly protruding feature having a first roundshape with a first radius; the second attachment interface comprises arecess having a second round shape with a second radius; and the secondgenerally semispherical shape of the recess is complementary to thefirst generally semispherical shape of the dome.
 17. The method of claim16, further comprising: bending at least one of: an arm of the boneplate; a central expanse of the bone plate; and a bone engagementfeature of the bone plate, in order to shape the bone plate to conformto at least one surface of the bone associated with the joint.
 18. Themethod of claim 17, further comprising: translating the bone plate withrespect to the arm of the bone plate; and compressing the bone plateagainst at least one surface of the bone associated with the joint priorto securing the bone plate to the bone associated with the joint. 19.The method of claim 16, further comprising: rotating the bone plate to adesired position with respect to the joint replacement prosthesis priorto securing the bone plate to the bone associated with the joint. 20.The method of claim 16, wherein the joint replacement prosthesiscomprises at least one of: a femoral joint replacement prosthesis; atibial joint replacement prosthesis; a fibular joint replacementprosthesis; a humeral joint replacement prosthesis; a clavicle jointreplacement prosthesis; a radial joint replacement prosthesis; an ulnarjoint replacement prosthesis; a digital joint replacement prosthesis;and an intramedullary nail.